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At least 721 records · Page 40Linked to original sources
PubMed1991

Reconstruction of the humerus by soft tissue distraction and vascularized fibula transfer.

We report a case of reconstruction of the humeral shaft by soft tissue lengthening according to the method of Ilizarov, followed by skeletal reconstruction with a vascularized fibular graft. Skeletal union and initiation of functional activity were achieved within 4 months. Lengthening of the soft tissue and the vascular tree by slow distraction did not compromise the subsequent reconstructive microsurgical procedure.

Adult↗
PubMedDate not supplied

Function of the upper extremity and ability to perform housework following reconstructive surgery of the shoulder joint using a free vascularized fibula bone graft: a case report.

The cases of two female patients who underwent reconstructive surgery using free vascularized fibular bone grafting of the proximal humerus are reported. Both patients were evaluated 1 year postoperatively for active range of motion; an Enneking evaluation and activities-of-daily-living (housework) assessment were also done. Patient 1 regained flexion and abduction to 110 degrees, and patient 2 regained flexion and abduction to 90 degrees. On the Enneking test, the patients achieved scores of 23 and 25 points, respectively. On the activities-of-daily-living housework assessment, patient 1 performed at 91.0% and patient 2 at 60.6%. In both cases, neither active range of motion nor the Enneking scores accurately reflected the functional abilities of the reconstructed limbs. It is important that upper extremity therapists evaluate and consider functional abilities in activities of daily living, such as housework, in the early phases of rehabilitation.

Activities of Daily Living↗
PubMedDate not supplied

Aneurysmal bone cyst of the fibula.

Aneurysmal bone cysts are benign, expansile lesions that are not at all uncommon in the lower extremity. These lesions are difficult to recognize clinically. This paper is a thorough review of the current literature regarding aneurysmal bone cysts. After this review, one should be able to diagnose and appropriately treat aneurysmal bone cysts. Also provided is a case report with classic histologic, clinical, and radiographic findings that was treated by en bloc resection.

Adult↗
PubMed2003

The histological structure of the malleolar groove of the fibula in man: its direct bearing on the displacement of peroneal tendons and their surgical repair.

The peroneal (fibularis) tendons are held in place within the malleolar groove by the superior peroneal retinaculum. If this is torn, the tendons can subluxate or dislocate. Understanding the anatomy of the region is important for treating these injuries when it becomes necessary to reconstruct the malleolar groove surgically. Serial transverse sections of the groove were cut from 10 dissecting room cadavers after routine histology processing. The structure of the malleolar groove differed significantly in its proximal and distal parts. Distally, the bone is convex and the shape of the groove is determined by a thick periosteal cushion of fibrocartilage that covers the bone surface. Proximally, the groove shape is determined by the bone itself, and the periosteum is thin and fibrous. The restriction of a periosteal fibrocartilage to the distal end suggests that it serves to adapt the shape of the malleolar groove to that of the tendons within it and thus promotes stress dissipation. Paradoxically, however, it increases the risk of damage to subluxated tendons, because these can be sliced longitudinally by a sharp ridge created from periosteal fibrocartilage when the retinaculum is torn. Our results suggest that if bone-block surgical procedures are used to reconstruct the malleolar groove, they are best restricted to its proximal part.

Aged↗
PubMed2000

[Desmoplastic fibroma of the fibula. A difficult clinical, radiological and histological diagnosis].

Desmoplastic fibroma of bone is a rare benign tumor that is made up of wavy fibroblasts and abundant collagenous tissue. The case of a 18-year-old patient is presented with a two months history of weightbearing pain in the left knee. Neither native x-ray, CT nor MRI could detect the kind of tumor. The histological findings lead finally to the diagnosis of a desmoplastic fibroma. Wide resection prevented recurrence of the tumor for 8 1/2 years until now. Considering the semi-malignant character of the desmoplastic fibroma and the recurrence rate marginal or wide resection for the primary treatment is recommended. The superior imaging quality of MRI facilitates preoperative planning.

Adolescent↗
PubMed2003

Enhancement of the fibula free flap by alveolar distraction for dental implant restoration: report of a case.

We describe the utilization of distraction osteogenesis in the free fibular microvascular bone graft to the mandible for increasing bone height for future osseointegrated dental implants. Successful reconstruction of a resected mandible requires restoration of both function and esthetic form. Although current reconstructive techniques restore anterior-posterior and lateral projection, often the graft's vertical height is not sufficient for the placement of osseointegrated dental implants and subsequent oral prosthesis. The patient was a sixteen-year-old male who was found to have a large desmoplastic fibroma of the left mandible, which was resected. The defect was successfully restored with a free fibular microvascular bone graft and reconstruction plate. Nevertheless, the patient had persistent problems with mastication and it was decided to perform a segmental osteotomy of the neomandible. Two internal vertical distraction devices were then placed in the mandible. The appliances were then activated five days postoperative, twice a day, for a total of 14 days. At that time 1.5 cm of distraction had occurred and the patient was placed in a consolidation phase for four months. The patient then had sufficient bone height and was restored with 8 osseointegrated dental implants.

Adolescent↗